title: Combining medical treatment and CBT in treating alcohol-dependent patients: effects on life quality and general well-being.
abstract: OBJECTIVE
  The aim of the study was to examine how the combination of medication and a brief cognitive behavioral intervention for alcohol dependency can affect patients' quality of life (QL), symptoms of depression and smoking habits.
  
  
  METHODS
  We conducted a randomized, open-label, multicenter naturalistic study for 243 voluntary-treatment-seeking alcohol-dependent adult outpatients in two phases: first, 12 weeks with continuous medication followed by targeted medication for up to 52 weeks, and second, a follow-up period of 67 weeks (altogether 2.5 years). The subjects were randomized 1:1:1 to receive supervised naltrexone, acamprosate or disulfiram, plus a brief manual-based cognitive behavioral intervention (CBT).
  
  
  RESULTS
  All three study groups showed a significant reduction in drinking from baseline to the end of the study. In the QL test EQ-5D, patients exhibited significant positive changes in sleeping, action, pain and mood dimensions. Severity of depression decreased during the whole study. Smoking decreased more in the disulfiram group than in the naltrexone and acamprosate groups.
  
  
  CONCLUSIONS
  A combination of medical treatment (naltrexone, acamprosate or disulfiram) with the CBT-booklet (patient guide) appears to help reduce patients' symptoms of depression and improve their QL. Treatment is also associated with success at quitting smoking, especially among patients using disulfiram.
authors.affiliation: Corresponding author: Department of Mental Health and Substance Abuse Services, National Institute for Health and Welfare, PO 30, 00271 Helsinki, Finland. hannu.alho@thl.fi.
authors.forename: E
authors.initials: E
authors.lastname: Laaksonen
authors.forename: S
authors.initials: S
authors.lastname: Vuoristo-Myllys
authors.forename: A
authors.initials: A
authors.lastname: Koski-Jannes
authors.forename: H
authors.initials: H
authors.lastname: Alho
mesh_terms: D000077443:Acamprosate; D000328:Adult; D000339:Affect; D000368:Aged; D000427:Alcohol Deterrents / Q000627:therapeutic use; D000437:Alcoholism / Q000188:drug therapy / Q000628:therapy*; D001007:Anxiety / Q000150:complications / Q000523:psychology; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D003131:Combined Modality Therapy; D003863:Depression / Q000523:psychology; D004221:Disulfiram / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007206:Individuality; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009271:Naltrexone / Q000627:therapeutic use; D009483:Neuropsychological Tests; D010349:Patient Compliance; D011788:Quality of Life; D012907:Smoking / Q000523:psychology; D013654:Taurine / Q000031:analogs & derivatives / Q000627:therapeutic use; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000427:Alcohol Deterrents; D013654:Taurine; D009271:Naltrexone; D000077443:Acamprosate; D004221:Disulfiram